Objective
To describe arthrodesis of the metacarpophalangeal (MCP) or metatarsophalangeal (MTP) joint with a locking compression plate (LCP) and a metallic tension band and report the outcome of horses treated for osteoarthritis (OA) with this technique.
Study design
Retrospective case series.
Animals
Seventeen horses with OA of the MCP or MTP joint treated with arthrodesis.
Methods
Medical records (2004‐2017) of horses treated for OA with arthrodesis of the MCP or MTP joint with an LCP and metallic tension band were reviewed. Preoperative variables included age, sex, breed, affected limb, and lameness grade. Surgical variables included implants used, surgery time, postoperative angle of joint, intraoperative complications, and anesthetic recovery method. Outcome was obtained from medical records and phone interviews.
Results
Lameness was scored as 4 out of 5 (range, 2‐4) in 13 of 17 horses. All horses survived to discharge and were alive >6 months postoperatively, without any report of long‐term complications. All horses were allowed unrestricted turnout, and 1 horse was lightly ridden. No postoperative infections or implant failures were reported. The only complications consisted of cast sores (n = 4).
Conclusion
Arthrodesis of the MCP/MTP joint was associated with acceptable morbidity and good long‐term outcomes in these 17 horses with OA refractory to medical management.
Clinical significance
The morbidity and prognosis after fetlock arthrodesis for OA seem more favorable than reported in horses treated with traumatic disruption of the suspensory apparatus.
The objective of this study was to determine the diagnostic ability of serum amyloid A (SAA) and fibrinogen for early detection of surgical site infection (SSI) after equine internal fixation. Horses undergoing internal fixation for fracture, arthrodesis, or osteotomy with internal fixation for limb deformity were included in the study. SAA and fibrinogen were measured on blood samples preoperatively and on days 1, 3, 5, 7, 10, and 14 postoperatively. Statistical analysis included use of Spearman's rank correlation, logistic regression, and calculating the area under the receiver operating characteristic (ROC) curve. SAA and fibrinogen measurements were both associated with SSI, with SAA being considered an excellent marker (area under the ROC curve 0.8) and fibrinogen being considered acceptable (<0.8). As the amount of time postoperatively increased, SAA elevations indicated a higher likelihood of SSI (area under the ROC curve 0.8 compared with fibrinogen 0.7). SAA and fibrinogen were predictive markers of SSI and SAA is of greater diagnostic utility when compared with fibrinogen. Persistent elevations of SAA postoperatively are associated with the development of SSI. Serial monitoring of SAA can be used to help predict the development of SSI in horses undergoing internal fixation. This may lead to earlier suspicion, and therefore recognition and treatment of SSI.
Objectives:Microfracture continues to be a dominant treatment strategy for symptomatic articular cartilage defects. Improving the histologic and clinical outcomes with biologic adjuncts offers promise to enhance this widely utilized technique. Specifically, the use of a novel scaffold that is potentially conductive and inductive such as micronized allograft articular cartilage (BioCartilage-BC) combined with platelet rich plasma (PRP) was investigated as an adjunct to microfracture in an equine model of articular cartilage defects.Methods:Five adult horses were anesthetized and 2 - 10mm diameter full thickness cartilage defects were created in the trochlear ridge in both knees; one proximal (high load) and another distal (low load). In one knee, microfracture (MFx) followed by grafting with BioCartilage(BC). BioCartilage was mixed with PRP and injected into the defect with a touhey needle and sealed with fibrin under CO2 arthroscopy. The opposite limb served as a control and received MFx only. Horses were euthanized at 13 months post-operatively. Outcome was assessed with serial arthroscopy, 3T T2 and T1rho MRI, microCT, and histology. Statistics were performed using a mixed effect model with response variable contrasts. P≤0.05 was considered significant.Results:No complications such as joint inflammation, infection or lameness were encountered. The score for overall repair (12=normal, 0=complete degeneration) in both the proximal and distal defects was significantly better in the BC group compared to MFx (proximal BC 7.4±0.51, MFx 4.8±.1; p=0.041)(distal BC 5.6±0.98, MFx 2.6±1.5; p=0.022). All significant findings on histology (100=normal, o=complete degeneration) were confined to the proximal, high load defects. Graft perimeter integration (BC 96±8.9, MFx 68±19; p=0.02), graft base integration (BC 100+/- 0.0, MFx 70±37;p=0.044), subchondral bone architecture under the graft (BC 66±18, MFx 34±16; p=0.050) and collagen type II BC 82+/-8, MFx 58±11; p=0.051. There were no significant differences between BC and MFx in MRI or uCT analyses.Conclusion:Micronized allograft articular cartilage (BioCartilage) and PRP improve cartilage repair compared to marrow stimulation alone in an equine model of articular cartilage defects. This technology offers promise for the use of homologous allograft tissue as a low-cost and safe augmentation procedure for traditional microfracture surgery.
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